threatened relapse should be rigorously observed. This is a rule of the utmost value and importance. Procrastination in treatment, under these conditions, is exceedingly dangerous. Promptitude in recognizing and treating relapse not only saves time, but it may avert hopeless intestinal atrophy.
Symptoms persisting.— In commencing this treatment, if the patient after two or three days be found unable to digest and assimilate so much as 3 pints of milk in the twenty-four hours, the daily allowance must be reduced by half a pint a day until 30 oz. or thereabouts only are taken. If now the motions become solid, the quantity of milk must be gradually increased by 5 or 10 oz. a day, so that in the course of a few weeks the full allowance— 6 or 7 pints— is consumed.
How to meet inadequate assimilation.— It sometimes happens that the quantity of milk can be raised to 70 or 80 oz. per diem, but no higher, further increase bringing on sore mouth, distension, and diarrhœa. In some of these cases the difficulty appears to depend not so much on digestion as on inability to absorb a large quantity of fluid. Occasionally, in such cases, one may succeed in getting the necessary amount of nutriment introduced by thickening the milk with condensed milk; or by slowly evaporating fresh cow's milk so as to reduce its bulk without diminishing the solids (Thin). The evaporation is best done in a vessel like a glue-pot, in which the milk is not boiled, but is surrounded by a jacket of boiling water; the milk during the process must be constantly stirred to prevent the formation of a scum. Or the milk diet may be supplemented by an adequate allowance of raw or underdone meat.
Other forms of giving milk.— Digestion is sometimes aided by peptonizing the milk; or by mixing it with lime-water or a little salt; or by aerating it in a soda-water siphon. Koumiss sometimes agrees for a time when ordinary milk fails, and, if necessary, should be tried. Similarly, white wine whey is occasionally digested when milk is not; it is often
